Liz wrote -
"Out of curiosity, is there a marked difference in the size of the breast. 
About 5 years ago we had a prenatal patient that was diagnosed with
intraductal CA.  The only varience from your information is the breast size
difference." 

Thanks to all who have given me their input - very very helpful.  Consensus
is that this mom is dealing with a deep bleb.  I've given mom your ideas.


Liz - I share your concern about the increased nipple size.  She is
currently on antibiotics (developed mastitis last week in the chronically
plugged zone) but this has not reduced the size of the nipple so infection
less likely to be cause.  I wondered if a bleb could be big enough within
the nipple (I have only seen them on the surface) to cause this increase in
size.

How would you diagnose intraductal cancer?  Mom has had ultrasound to look
for abnormalities as this was her concern too, but nothing found.

Her breasts are symmetrical - perhaps left one is a little bigger but
variance in milk production could account.

As the skin is very sensitive I have referred her to a dermatologist who
specializes in breastfeeding problems.  Figured this physician might be able
to rule out significant pathology as she must see so many women with nipple
pain not responding to all the usual (and unusual!!) approaches.

Joanna Koch, IBCLC

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